Drug resistance is becoming a serious issue worldwide.Obtaining accurate antimicrobial susceptibility results requires refined standard operation procedures,thus achieving the goal of individual therapy.The interpretive criteria CLSI revised annually causes widespread concern of clinical microbiologists.The major changes in CLSI M100-S25 are described in this article,focusing on the introduction of Carba NP confirmatory test for suspected carbapenemase production and epidemiological cutoff values.

Individualized therapy is dependent on rapid and accurate diagnosis of pathogens,and refined susceptibility reporting.The annually revised interpretive criteria of Clinical and Laboratory Standards Institute (CLSI) causes widespread concern of microbiologists.The major changes in CLSI M100-S24 are described in this article.The document mainly changed the Cefepime breakpoint for Enterobacteriaceae and introduced a new concept-- susceptible-dose dependent interpretive category.Optimizing the use of antimicrobial agents requires clinical microbiologists and clinicians to have a good knowledge of the new breakpoints.

Objective To evaluate the effects of fructose-1,6-diphosphate (FDP) on the preservation and high-energy phosphate metabolism of hypothermic SD rat hearts. Methods Sixteen SD rats were randomly divided into 2 groups. Their hearts were harvested and preserved in UW solution at 4℃ for 12 hours. In the study group (n=8), FDP (5mmol/L) was added to the UW solution, whereas in the control group, FDP was not added. Langendorff perfusion was established with the isolated hearts, and cardiac functions were examined, as well as the activities of lactate dehydrogenase (LDH) and creatine kinase (CK) in the perfusion fluid collected from coronary. Then the high-energy phosphate concentration, ATP, ADP, and AMP contents in the myocardium were determined with HPLC. Results The high-energy phosphate concentration was remarkably higher in the study group than that in the control group (P

0.05).The acute rejection rates in non-dialysis group was significantly lower than that of dialysis group(19.53% vs 34.27%,P0.05).The 1 year survival rates of patient/graft were 98.44% in non-dialysis and(97.72%/)95.96% in dialysis group(no significance);the 3 year survival rates of patient/graft were 96.23% in nondialysis and(94.4%/88%) in dialysis group(no significance).Conclusion:Renal transplantation without dialysis can avoid the dialysis complications and transfusion-induced sensitization,and reduce the risk of hepatitis infection as well as the acute rejection rate;while its patient/graft survival rate is similar to that of dialysis renal transplantation,making it feasible for clinical application.

Objective To summarize the experiences of kidney retransplantation from 1978 to Dec. 2002.Methods The clinical data of 86 cases subject to first renal transplantation and 86 cases to second renal transplantation were retrospectively analyzed. The main causes of failure of the first renal transplantation were CAN, while those of the second renal transplantation were HAR, and other complications such as AR, graft rupture and serious graft T.B. PRA or CDC in 31 cases was positive before retransplantation. The clinical data such as antibody-inducing therapy, the protocols of immunosuppression and the survival rates of patients and grafts in these patients were analyzed.Results Survival rates at 1, 3, 5 year of the patient/graft of retransplantation group were 84.8 %/61.6 %, 79.1 %/45.3 % and 58.1 %/41.9 % respectively, while those at 1, 3, 5 years of the patient/graft with the first renal transplantation were 89.5 %/79.1 %, 81.4 %/74.4 % and 67.4 %/58.1 % respectively. No significant difference in the patient survival rates and graft survival rates was observed (P

Objective To investigate the technical features, postoperative complication and therapeutic regimen of immunosuppressant in pediatric and adolescent renal transplantation. Methods From February 1998 to December 2004, clinical data of 46 pediatric and adolescent patients who underwent renal transplantation were retrospectively analyzed to observe the patient and graft survival rate, growth and development of recipients and postoperative complication. Results Ten episodes of acute rejection (AR) were diagnosed in 46 cases. Four cases suffered delayed graft function (DGF), one urinary leakage and 8 drug-induced hepatic injury occurred. Eight cases suffered pulmonary infection, 3 cases suffered bone marrow depression and 2 granulocytopenia. One allograft artery stenosis and one ureteral necrosis occurred. Renal functions were returned to normal in all recipients 4 weeks after operation. The 1-year patient and graft survival rates were all 100 %, and the 3-year patient and graft survival rates were 100 % and 97.4 % respectively. Conclusions Renal transplantation is an effective treatment for pediatric and adolescent patients with end-stage renal disease. In addition to its higher AR incidence than adult, pediatric renal transplantation has especial treatment in the operation process and therapeutic regimen of immunosuppressant.

Objective To investigate the features of kidney transplantation in patients over 60 years old.Methods From May 1998 to Oct. 2001,the clinical data of 81 cases over 60 post kidney transplantation were retrospectively analysed and compared with those of 432 patients below 60 age. Results The dialysis time of senile group was longer and the hypoproteinemia was sever than that of control group (P 0.05). The postoperative incidence of pulmonary infection was higher(P

ObjectiveTo observe the relativity between cerebral infarction and dyslipidemia in patients with diabetes mellitus (DM).MethodsThe blood glucose and lipid of 66 DM cases and 30 normal healthy persons (as control group) were tested.ResultsIn the blood lipids of the diabetes group without vascular disease, only densities of triglyceride (TG), apolipoprotein A-Ⅰ (apoA-Ⅰ), apolipoprotein B (apoB), apoA-Ⅰ/apoB changed significantly compared with the control group (P<0.05), others without significant change. But blood lipids level of cerebral infarction group was significantly higher than that of the control group (P<0.01). In DM group, the patients with cerebral infarction had higher fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), TG, low density lipoprotein cholesterol (LDL-ch), apoB, α-lipoprotein (LPα), but lower apolipoprotein A1 (apoA1) and apoA-Ⅰ/apoB than those of the without vascular disease group (P<0.05 or P<0.01).ConclusionDyslipidemia has some relativity with the cerebral infarction of DM.

OBJECTIVE:To observe clinical efficacy of extracorporeal shock wave lithotripsy combined with Paishi decoction in the treatment of kidney stone. METHODS:160 patients with kidney stone were selected and randomly divided into observation group and control group,with 80 cases in each group. Control group only received HB-ESWL-VG extracorporeal shock wave litho-tripsy;observation group additionally received Paishi decoction 300 ml,tid,for consecutive 1 week,on the basis of control group. Clinical efficacy was observed in 2 groups;the levels of serum inflammatory factor IL-2,IL-6,TNF-α,T lymphocyte subset CD3+,CD4+,CD8+ and CD4+/CD8+,erythrocyte immune function indicator C3b receptor rosette(C3bRR),immunity complex ro-sette(ICR)and tumor erythrocyte rosette(TER)level were detected in 2 groups before and after treatment. RESULTS:The effec-tive rate of observation group(98.75%)was significantly higher than that of control group(91.25%),with statistical significance (P<0.05). After treatment,the levels of IL-2,IL-6 and TNF-α in observation group was significantly lower than in control group, the levels of CD3+,CD4+,CD4+/CD8+,C3bRR,ICR and TER were significantly higher than control group,with statistical signifi-cance(P<0.05). Comparsion of CD8+between 2 groups was not statistically significant(P>0.05). CONCLUSIONS:The extracor-poreal shock wave lithotripsy combined with Paishi decoction can relieve inflammation reaction,enhance immune function and im-prove therapeutic efficacy.

Ascending and descending efferent projections of superior coUiculus were indentified by means of the anterograde horseradish peroxidase technique in the cat.Following injections of HRP into the rostral superior colliculus, a large number of labeled terminals were found mainly in several of the ipsilateral thalamic nuclei:ventromedial division of the ventral nucleus of the lateral geniculate body, zona incerta,lateral posterior nucleus, parafasciculus nucleus and centromedian nucleus. The mediodorsal nucleus and thalamic reticular nucleus were also found mildly labeled.Labeling were most heavily concentrated in the ipsilateral dorsolateral division of pontine nucleus and caudal region of parabigeminal nucleus. The dorsal part of medial accessory olivary was the only nucleus labeled contralaterally. After injecting HRP into the caudal superior colliculus, only the dorsolateral division of pontine nucleus was densely labeled, while labeled terminals of caudal parabigeminal nucleus signifcantly reduced in amount. No labeled terminals were found in the thalamus as well as medial accessory olivary nucleus. These results indicate that the efferent connections of superior colliculus are topographically organized.